The foramen ovale is a hole between the 2 upper chambers of the heart (the atria).
The heart has 4 sections, or chambers. The upper chambers are each called atria, and the lower chambers are called ventricles. The heart muscle squeezes to push blood through these 4 chambers, to the lungs, and to the rest of the body. Blood flows from the right atrium into the right ventricle, and the right ventricle pumps it to the lungs. As it passes through the lungs, the blood picks up oxygen and leaves behind carbon dioxide. Then the blood flows back to the heart and into the left atrium, and from there into the left ventricle. The left ventricle pumps the blood out to the rest of the body, with a small amount going to the heart muscle itself. The heart pushes blood out through the arteries and blood returns to the heart through the veins.
A foramen ovale is normally present before birth and closes in most children after birth. If the hole does not close all the way, it is called a patent foramen ovale (PFO).
Before birth, a baby’s blood does not need to go through the lungs to pick up oxygen because the baby gets oxygen-rich blood from the mother. After birth, increased blood pressure on the left side of the heart normally forces a flap over the hole to seal it, so all of the blood then travels from the right side of the heart to the lungs.
Sometimes the flap does not seal. When this happens, the foramen ovale may open at times, and less blood will get to the lungs to pick up oxygen.
It is not known why the flap seals after birth in most people but not everyone.
A PFO usually does not cause any symptoms. In rare cases, a baby with PFO may turn blue when crying or straining to pass a bowel movement.
PFO can cause some problems in adults. For example:
Your healthcare provider will ask about your child’s symptoms and medical history and examine your child. Your child may also have an echocardiogram, which uses sound waves (ultrasound) to show pictures of the heart and how well blood is flowing through it.
Most children with PFO do not need treatment.
Your child may need blood thinners to lower the chance of blood clots that might cause a stroke.
The hole may need to be closed if your child is not getting enough oxygen from the lungs or to prevent another stroke. This may be done during:
Your child should have regular checkups. Your child may need to have regular follow-up visits with a specialist in congenital heart disease.
Follow your child’s healthcare provider's instructions. Ask your provider:
Make sure you know when your child should come back for a checkup. Keep all regular checkup appointments with your child's healthcare provider.